(3 years, 7 months ago)
Lords ChamberMy Lords, it is my privilege to congratulate the noble Lord, Lord Lebedev, on his maiden speech. Like many, I am sure, I wish to hear more from him. Though a young man, he has an extraordinary range of experience of charitable and philanthropic action and as a proprietor of the Evening Standard—how many of us worry about evening newspapers all over the country surviving? The Independent has been a great newspaper for those who have broad views but no fixed political commitments. We wish to hear more.
This debate is taking place at a very opportune moment. I welcome one thing that I have been pressing for ever since the ill-fated reforms from the noble Lord, Lord Lansley, came before us. It is essential to return to the situation where the Secretary of State holds the democratic responsibility for the running of the National Health Service. I hope that when this power is restored it will be a duty of the Secretary of State to promote in England
“a comprehensive health service designed to secure improvement … in the physical and mental health of the people of England, and … in the prevention, diagnosis and treatment of … illness”,
and for that purpose to provide or secure the effective provision of services. I want a legal responsibility of answerability in this House, which we have not had for seven years, but we have had the largest quango in the world. This must come; I have been arguing for it in an NHS reinstatement Bill for seven years.
When we look at the Covid situation and the wonderful way in which the NHS and those who support it responded in a crisis, we need to understand the NHS’s unpreparedness following 20 years of structural vandalism, with hospitals no longer serving geographical areas. The incoherence and fragmentation of an unrecognisable NHS came about through four legislative Acts: in 2002, 2006, 2008 and, above all, in the ill-fated Health and Social Care Act 2012.
We must look back, post Covid, for reasons that have already been advanced. I do not have the massive criticisms of what has happened that seem to pour out, day after day. There have been many great achievements, but let us be clear about the problems and the predicted problems. In December 2016, at an international conference as a result of the Cygnus simulation exercise of an influenza pandemic a couple of months earlier, the then Chief Medical Officer, Sally Davies, made it clear that we could not cope with the excess bodies and faced the threat of inadequate ventilation. This was a Chief Medical Officer of health revealing the situation, four years before it faced us. Why was nothing done? Did she make representations to the then Secretary of State, Jeremy Hunt? Did she take these issues up right through?
What about the prevention of ill health itself, which has been neglected for years in the health service and constantly forgotten? It is all too easy to spend on the headlines—we have had enough headlines out of Sir Simon Stevens—but why was more not done to prepare? Why was NHS bed occupancy at 100%? It did not happen just with Covid; it happened way before that. There were levels of 98%. We used to think it was wise to have 75% bed occupancy. There is this whole idea that the NHS can be run like a marketplace, where you maximise your profits at all stages and run things at 100%. The NHS is very different. I urge the House to get to grips with it in a way that we never did seven years ago with the legislation that went through.
I also ask the House to look at some of the other problems that we will face. Mental health has been neglected for years—look at the fall in psychiatric nurse numbers. Yet speech after speech, whether from Ministers or health administrators such as Sir Simon Stevens, talks up new ideas and initiatives, when staring us in the face are basic deficiencies in how our mental health service is run and what it needs. We will face this ever more than before now that Covid has hit us. Post-Covid illness will affect the young in particular.